Florida's premature birth grade rises from F to D
Published: Tuesday, November 1, 2011 at 6:18 p.m.
Last Modified: Tuesday, November 1, 2011 at 6:18 p.m.
Florida is making strides in giving babies the best chance to be born healthy, but the state still has much work to do, according to the March of Dimes.
The state received a D grade on the March of Dimes' annual prematurity report card, up from a failing grade the previous year.
The March of Dimes calculated this year's grades using the state's rate of premature births from 2009 and the group's goal of having no more than 9.6 percent of births being premature by 2020 — what the group determined is the lowest rate achievable through reducing the impact of three contributing factors.
The state saw a decline in the number of pregnant women who smoke as well as the percentage of late preterm births, or births between 34 and 36 weeks.
Donna Pointer, program coordinator of the March of Dimes of North Central Florida, said more women are electing to give birth before they are full term at 40 weeks.
"The last three to four weeks of pregnancy, there's still so much development," she said. "Unless there is a medical reason for that, we should never schedule an induction of labor or C-section prior to 39 weeks."
Dr. Anthony Gregg, professor and director of the maternal-fetal medicine division at the University of Florida College of Medicine, said scheduling an induction tends to be a matter of convenience.
"In some cases they have in-laws coming into town, they have children that may be off of school, they have job-related issues," he said. "Sometimes it's done out of fear. They may have had an unusual event in a previous pregnancy where their anxiety level is unusually high."
Gregg said 10 percent of births in the 1990s nationwide were induced, compared with more than 25 percent in recent years.
Shands and other hospitals have installed a computer-based method of monitoring to help ensure that early deliveries and inductions are scheduled for the proper reasons, Gregg said.
It "becomes a little bit easier for doctors to say, ‘I'm not able to do this,' " he said.
Part of the problem, Pointer said, is simple math.
"Unfortunately all of these years, we've told people nine months to have a baby," she said. "When you multiply 9 by 4, it's 36 weeks."
The percentage of women smoking while pregnant dropped nearly two percentage points in Florida to 17.3 percent, according to the report card.
"We were very, very happy about that, because we don't want women smoking while they're pregnant," Pointer said. "It's a contributor to preterm births."
Smoking during pregnancy can lead to birth defects, prematurity, low birth weight and stillbirth.
Gregg said that as part of routine care, the hospital offers smoking cessation aids as well as education.
"We can't guarantee that patients will take us up on the offer," he said. "Patients will have to want to discontinue the addiction."
The biggest factor keeping Florida in the failing range is that the percentage of uninsured women continues to grow, Pointer said. The percentage of childbearing-age women who are uninsured grew nearly a percentage point to 28.5 percent.
"That's almost a third of all pregnant women in Florida that don't have insurance," she said. "Let's at least get those women of childbearing age insurance. That's where to start."
Gregg said that even for women who are insured, getting the preventive measures for women at risk of delivering before 34 weeks is difficult.
"There has to be, from my perspective, greater awareness at the state and local levels as well as private industry," Gregg said. "One of the things we have to do is recognize that sometimes an ounce of prevention is worth a pound of cure."
Reader comments posted to this article may be published in our print edition. All rights reserved. This copyrighted material may not be re-published without permission. Links are encouraged.